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      <h4 class="scenarios"><a href="implementation.html" class="blue">NwHIN 1.0 Portfolio</a> > <a href="scenarios.html" class="blue">Scenarios</a> > <a href="scenario_qh2.html" class="blue">Sending a Patient a Reminder</a></h4>
      <h1 class="testimonials">Sending a Patient a Reminder</h1>
      <h6>A physician sends a reminder for preventive care to a patient:</h6>
      <div class="scenario_center"><p><img src="images/scenario_QH2.png" alt="S&amp;I Functions" title="A flow diagram illustrating the transmittal of a reminder message from a physician to a patient. The physician’s EHR automatically generates an electronic reminder and sends it to the patient’s Direct address. The message passes through the physician’s HISP, where it is encrypted and sent to the PHR’s HISP. The PHR’s HISP decrypts the message, routes it to the patient’s PHR Direct inbox, and sends a notification to the patient’s personal email. The patient then logs into her PHR to view the Direct message."/></p></div>
      <p>A patient&rsquo;s primary care physician recommends that all patients over the age of 65 get annual influenza vaccines. As a convenience, the primary care physician&rsquo;s EHR automatically sends the patient an electronic reminder to make a vaccination appointment. The message is sent via Direct to the patient&rsquo;s personal health record (PHR) Direct inbox. The PHR&rsquo;s Direct messaging service then sends a notification email to the patient&rsquo;s personal email address, indicating that a new message has arrived at her Direct inbox. The patient logs onto her PHR, from which she can retrieve the new Direct message. She reads the reminder, schedules an appointment with her primary care physician to receive the vaccination, and deletes the message.</p>
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         <td width="40" align="left" valign="top"> <img src="images/clipboard_check.png" alt="Meaningful Use Objectives" /> </td>
         <td width="15">&nbsp;</td>
         <td valign="middle"><p class="mu"><strong>Meaningful Use Stage 2 Objectives related to patient reminders:</strong> Use clinically relevant information to identify patients who should receive reminders for preventive/follow-up care. (<em>Meaningful Use Menu Set 12 for EPs</em>)</p></td></tr></table>
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     <h6>Common workflow steps for this scenario:</h6>
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         <td width="891" valign="middle">The primary care physician&rsquo;s EHR generates an automatic reminder message to the patient.  The Direct address provided by the patient is entered as the &ldquo;recipient&rdquo; for the message. Prior to sending, the digital certificate associated with the patient&rsquo;s Direct address is located following the Certificate Discovery for Direct implementation guide.</td>
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         <td width="40" align="left" valign="top"> <img src="images/scenario_2.png" alt="2" /> </td>
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         <td width="891" valign="middle">When the primary care physician sends the message, it passes through the primary care physician&rsquo;s Health Information Service Provider (HISP), a contracted brokering agent responsible for the management of security and transport for directed exchange. As it passes through the HISP, the message is encrypted using the x.509 Certificate associated with the patient&rsquo;s Direct address, and delivered to the patient&rsquo;s Direct address in accordance with the Applicability Statement for Secure Health Transport.</td>
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         <td width="40" align="left" valign="top"><img src="images/scenario_3.png" alt="3" /> </td>
         <td width="15">&nbsp;</td>
         <td width="891" valign="middle">The message is received at the patient&rsquo;s Direct address by the PHR&rsquo;s HISP. An automated email notification is sent from the patient portal to the patient&rsquo;s personal, non-Direct email address alerting her of the new secure message that awaits on the PHR Direct inbox.</td>
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         <td width="40" align="left" valign="top"><img src="images/scenario_4.png" alt="4" /></td>
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         <td width="891" valign="middle">When the patient logs into the PHR, she accesses her Direct inbox and views the reminder message.</td>
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      <h6>NwHIN 1.0 specifications and resources recommended for scenario:</h6>
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      <h4 class="scenario2">Transport and Security</h4>
        Mechanisms and processes that safely exchange health information over the Internet
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    <td align="left" valign="middle" bgcolor="#E6E6E6"><ul>
      <li><a href="http://wiki.siframework.org/file/view/Certificate Discover for Direct Project Implementation Guide.pdf" target="_new">Certificate Discovery using Domain Name System (DNS) and Lightweight Directory Access Protocol (LDAP)</a></li>
      <li><a href="http://wiki.directproject.org/Applicability+Statement+for+Secure+Health+Transport" target="_new">Applicability Statement for Secure Health Transport</a></li>
      <li><a href="http://tools.ietf.org/html/rfc5280" target="_new">x.509 for Certificates</a></li></ul></td>
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